红霉素与甲泼尼龙冲击疗法联用治疗小儿肺炎支原体大叶性肺炎的效果探讨

Effect of Erythromycin Combined with Methylprednisolone Pulse Therapy in the Treatment of Children with Mycoplasma Pneumoniae Lobar Pneumonia

目的探讨小儿肺炎支原体大叶性肺炎治疗中应用红霉素联合甲泼尼龙冲击疗法的效果。方法选择2019年3月-2021年2月南京中医药大学附属沭阳中医院收治的80例小儿肺炎支原体大叶性肺炎患者。以随机数表法分为两组,对照组40例,给予红霉素治疗;观察组40例,联合甲泼尼龙冲击疗法治疗。治疗后,比较两组患儿治疗效果。结果治疗7 d后,观察组白细胞计数(8.42±1.49)×10^(9)/L、中性粒细胞(0.41±0.10)%及血小板计数(215.28±8.63)×10^(9)/L均低于对照组的(11.42±2.03)×10^(9)/L、(0.62±0.14)%、(286.32±10.65)×10^(9)/L,淋巴细胞比例(0.41±0.13)%高于对照组的(0.32±0.10)%,差异有统计学意义(t=7.535、7.720、32.777、3.471,P<0.05);观察组患儿发烧消退时间(2.13±0.34)d、肺部啰音消失时间(4.31±0.74)d、咳嗽消失时间(5.42±0.82)d、喘息消失时间(4.14±0.78)d及咳痰消失时间(4.68±0.70)d均短于对照组,差异有统计学意义(t=17.811、16.892、18.071、18.269、16.300,P<0.05);治疗7 d后,观察组D-D(0.13±0.06)mg/L、CRP(5.61±0.73)mg/L、ESR(20.15±3.25)mm/h、PCT(0.14±0.05)ng/mL均低于对照组,差异有统计学意义(t=23.388、18.097、10.112、15.339,P<0.05);观察组治疗期间不良反应(腹痛、面部潮红、皮疹过敏及肝肾异常)发生率2.50%低于对照组的5.00%,差异无统计学意义(χ^(2)=0.000,P>0.05)。结论红霉素联合甲泼尼龙冲击疗法用于小儿肺炎支原体大叶性肺炎中能改善血常规水平,缩短症状消失时间,降低炎性因子水平,不良反应发生率低,值得推广应用。

Objective To investigate the effect of erythromycin combined with methylprednisolone pulse therapy in the treatment of children with Mycoplasma pneumoniae lobar pneumonia.Methods A total of 80 children with Mycoplasma pneumoniae lobar pneumonia who were admitted to Shuyang Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from March 2019 to February 2021 were selected.They were divided into two groups by random number table method,40 cases in the control group were treated with erythromycin;40 cases in the observation group were treated with methylprednisolone pulse therapy.After treatment,the therapeutic effects of the two groups were compared.Results The white blood cell count(8.42±1.49)×10^(9)/L,the neutrophil count(0.41±0.10)%and the platelet count(215.28±8.63)×10^(9)/L in the observation group after 7 days of treatment all were lower than those of the control group(11.42±2.03)×10^(9)/L,(0.62±0.14)%,and(286.32±10.65)×10^(9)/L,the proportion of lymphocytes was(0.41±0.13)%higher than that of the control group(0.32±0.10)%,and the difference was statistically significant(t=7.535,7.720,32.777,3.471,P<0.05);in the observation group,the fever subsided time(2.13±0.34)d,the lung rales disappeared time(4.31±0.74)d,the cough disappeared time(5.42±0.82)d,the wheezing disappeared time(4.14±0.78)d and the expectoration disappearance time(4.68±0.70)d all were shorter than the control group,and the difference was statistically significant(t=17.811,16.892,18.071,18.269,16.300,P<0.05);after 7 days of treatment,D-D(0.13±0.06)mg/L,CRP(5.61±0.73)mg/L,ESR(20.15±3.25)mm/h,PCT(0.14±0.05)ng/mL in the observation group were lower than those in the control group,the difference was statistically significant(t=23.388,18.097,10.112,15.339,P<0.05);the incidence of adverse reactions(abdominal pain,facial flushing,allergic skin rash and abnormal liver and kidney)in the observation group during treatment was 2.50%lower than that in the control group(5.00%),the difference was not statistically significant(χ^(2)=0.000,P>0.05).Conclusion Erythromycin combined with methylprednisolone pulse therapy for children with Mycoplasma pneumoniae lobar pneumonia can improve blood routine level,shorten the time of symptom disappearance,reduce the level of inflammatory factors,and the incidence of adverse reactions is low,which is worthy of popularization and application.